The discord and chaos created by the hospital's new management team causes one physician to question his future at Seattle Grace. Meanwhile, the doctors and the interns must juggle several transplant surgeries at once, each coming with its own set of obstacles.

Recap

The episode begins with Arizona and the others upset that Jackson has a bigger say than they do in hospital matters. Webber argues with Catherine about it, but she says she has made a good decision. Jackson shows up late to their meeting. Cristina suggests waiting for Hunt to join the conversation. Jackson says the foundation thinks new leadership would help morale, so Hunt will be let go. None of the doctors are happy to hear this. Jackson takes the position that they should be grateful the foundation saved the hospital. ..

Meredith: (opening voiceover) To a critically ill patient, an organ transplant means a new start, a second chance. But the body is designed to fight off any outside invader, even one that's trying to save it. Because a transplant doesn't guarantee that it's an easier life. There's a threat that the body will reject the organ outright.

Cristina: You know, I don't care who's giving you your marching orders, this thing with Owen is not happening.Jackson: Say what you want, but without the Harper Avery Foundation, none of us are here.Meredith: And we appreciate that. But no one expected them to come in and start dictating policy.Jackson: Yeah, well, no one asked you to sue the hospital into bankruptcy either.Meredith: For the plane crash that killed Lexie?

April: Hey, have you guys seen Chief Hunt? I would like to know why he signed a death warrant on one of my patients.Bailey: Well, good luck. He's gone. He quit.April: He... what? Hunt?Bailey: Ask boss man over here.Jackson: There was a disagreement about policy.April: Yeah, well, then change the stupid policy.Bailey: Unh-unh, not before he changes my stupid policy first.

Meredith: You want me to apologize, Alex? I'm sorry. I'm sorry we bought the hospital. I'm sorry you have to think of us as your bosses now. But we didn't do it for just us. We did it for everyone, for you, for Wilson, who, by the way, fought so hard for you today, I thought she might cut someone to get you that kidney. So drop the attitude before nobody wants to work with you any more.

Jackson: We are building a new hospital. And that was your vision, not mine. My priority is to make sure your vision comes true. And while it is important that we become a leading centre for research and innovation, we have to remember something, we are now officially a hospital run by doctors. That should mean something. It is our responsibility to be the best doctors we can possibly be so that those who come after us can strive to be their best.

Meredith: So you'll have to pick up Zola. Did you sort out the OR board?Derek: I started, but I have a surgery. I have Torres looking into it right now. Why are you on a plane?Meredith: Because Alex wants his kid's kidney mobilised before perfusion and he's being a giant baby about it.Derek: Alright. Call me when you get back.

Meredith: (closing voiceover) The transplant process is very scary. A patient goes from worrying about getting an organ to worrying if the organ will be rejected. The anxiety continues until they can finally open their eyes after surgery and see that their gift has been accepted.

Episode Goofs

Continuity:

When Derek get's out of his car to talk to Owen he closes the door of his Porsche Cayenne. In the next shot, the driver's door is open in the background.

Cultural References

Episode Title: Transplant Wasteland

Transplant Wasteland is the title of a song originally sung by Arcana.

Episode References

Season 9, Episode 16: The doctors bought the hospital with the help of Dr. Catherine Avery and the Harper Avery Foundation at the end of 9x16 "This Is Why We Fight".

Season 9, Episode 15: When Derek and Owen argue, Owen says that it is all Derek's fault. He says "I thanked you, and then an hour later you walked out." He is referring to the incident in 9x15 "Hard Bargain" when Derek and the rest of the plane crash victims quit the hospital.

Season 9, Episode 1: Derek tells Owen that he is angry at the world, and angry at Mark. He means that he is angry at Mark Sloan, his best friend, for dying during 9x01 "Going, Going, Gone".